Healthcare Preview: Week of November 8, 2021 - McDermott+Consulting

Healthcare Preview: Week of November 8, 2021

Health Care Front and Center

Negotiations on the Build Back Better Act Continue. Last week, the House passed the bipartisan infrastructure bill (BIF) after a dramatic day that saw the longest open vote in the history of the House of Representatives. The House also passed the rule to allow for debate on the Build Back Better Act (BBB) and released updated text and then a Manager’s Amendment that further updated the text of BBB during a marathon Rules Committee meeting. However, at the 11th hour, Speaker Pelosi was thwarted in her attempt to pass BBB on Friday by moderate Democrats who insisted they wanted a score from the Congressional Budget Office (CBO) before voting.

This week, all eyes turn to the CBO to see if they can produce a score for BBB, a massive piece of legislation that creates various new programs and policies. In addition, Democratic Leadership has promised this legislation will be fully paid for, so Members will also be looking for CBO to confirm that. If CBO comes out with a lower score, the legislation may need to be re-opened to include additional payfors. That would mean the House would need to start over with a new rule vote. That would open the door to additional changes to secure the near-unanimous Democratic support needed to pass the BBB.

Senate Democrats are also contending with the progressive and moderate factions within their Caucus as they anticipate action from the House on BBB. It is still unclear which provisions will survive the Byrd Rule, including the new language added by the House on immigration. In addition, key Senators will could decide to raise concerns and stop the process in its tracks. And, presuming it gets through the Senate, changes from the House bill due to the Byrd process and the need to have all 50 Democrats in agreement will mean it has to go back to the House for final passage.

Bottom line: This isn’t wrapping up anytime soon.

After intense negotiations, the House voted on the President’s $1.75 trillion economic package and infrastructure bill on Friday, paving the way to advance the Build Back Better Act. Debbie Curtis and Rodney Whitlock recap the last-minute changes to the Bipartisan Infrastructure Bill and preview the next steps for Democratic leadership.